Office and mailing address: PHILIPPINE NATIONAL BANK 316 W. 2ND Street Suite 700 Los Angeles Branch Los Angeles, CA 90012 OWN A PHILIPPINE HOME LOAN APPLICATION I. AMOUNT AND TERM OF LOAN Tel. No. (213) 401-1800/Fax No. (213) 401-1803 Amount Requested: $ Term Requested: 10 years 15 years 20 years II. PROPERTY INFORMATION AND PURPOSE OF LOAN Description of Subject Property OCT/TCT/CCT no. in the name(s) of Lot no. Block no. Area (sqm): Address: Property type: Purpose of Loan : Residential Commercial Industrial Purchase of Lot only House Construction only Purchase of Lot & House Construction Purchase of House & Lot House Improvement/Renovation Others: Purchase of Condominium/Townhouse Unit Complete this portion if house construction or renovation loan. Refinance Existing Home Mortgage Year Lot/Property Acquired Original Cost Amount of Existing Liens (a) Current Value of Lot (b) Cost of Improvements Total (a + b) $ $ $ $ $ - Complete this portion if this is refinancing Description of property offered as collateral: Year Acquired Original Cost Amount of Existing Lien Purpose of Refinance $ $ Title will be registered or held in whose name/s (for purchase of property): Title is presently held in whose name/s (if construction/renovation loan or refinancing): Source of down payment and payment for fees and charges (ex: salary, self-employment or business income, personal savings, borrowed funds, etc.): SECTION A - INFORMATION REGARDING BORROWER III. BORROWER INFORMATION SECTION B - INFORMATION REGARDING CO-BORROWER Borrower's Name (Include Jr. or Sr., if applicable) Citizenship Co-Borrower's Name (Include Jr. or Sr., if applicable) Citizenship Social Security No. Home phone Celphone DOB(mm/dd/yyyy) #yrs in sch Social Security No. Home phone Celphone DOB(mm/dd/yyyy) # yrs in sch Married Unmarried (includes single, Dependents Married Unmarried (includes single, Dependents divorced, widowed) No. Ages divorced, widowed) No. Ages Separated Separated Present Address (street, city, state, ZIP) Own Rent yrs Present Address: Own Rent yrs Email address: If residing at present address for less than two years, please complete the following: Email address: Former Address (street, city, state, ZIP) Own Rent yrs Former Address (street, city, state, ZIP) Own Rent yrs Former Address (street, city, state, ZIP) Own Rent yrs Former Address (street, city, state, ZIP) Own Rent yrs BORROWER IV. EMPLOYMENT INFORMATION CO-BORROWER Name & Address of Employer: Self-employed Yrs on this job Name and Address of Employer Self Employed Yrs on this job Yrs employed in this line of Yrs employed in this line of work/profession work/profession Position/Title/Type of Business Business phone Business fax Position/Title/Type of Business Business phone Business fax Responsible person at Personnel/Admin./HR Dept. Fax no.: Responsible person at Personnel/Admin./HR Dept. Fax no.: Email: Email: If employed in current position for LESS THAN two years or if currently employed in MORE THAN one position, please complete the following: Name & Address of Employer Self Employed Dates (from-to) Name & Address of Employer Self Employed Dates (from-to) Monthly Income Monthly Income Position/Title/Type of Business Business phone Business fax Position/Title/Type of Business Business phone Business fax Name & Address of Employer Self Employed Dates (from-to) Name & Address of Employer Self Employed Dates (from-to) Monthly Income Monthly Income Position/Title/Type of Business Business phone Business fax Position/Title/Type of Business Business phone Business fax
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